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Patient Data

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Sagittal T2

T6-10 left lateral thoracic meningocele with complex dural folds. Markedly distorted spinal cord with reduced volume, cord displaced anteriorly and to the left. Nerve rootlets can be seen transversing the fluid space to reach the right side. Lateral expansion of meningocele through left T8/9 and T9/10 foramina.

Lipoma/entrapped fat seen on dorsal aspect of the cord at the superior aspect, forming a "placode-lipoma interface" within the spinal canal. Lipoma is contiguous with posterior epidural fat, and has a circumferential dural envelop (which becomes thickened and more obvious post-shunting - not shown).

Case Discussion

Findings suggest this being a type of lateral thoracic meningocele.

However, the presence of entrapped fat/lipoma abutting the cord, complex dural folds, as well as deformed and diminished spinal cord suggest that this is more like a developmental/congenital "lipomyeloschisis", rather than dural deformity/ectasia seen in mesenchymal diseases such as neurofibromatosis type 1 and Marfan syndrome. Yet the posterior bony elements are intact.

There is no clear-cut terminology to use - is this a meningocele, lipomeningocele, or lipomyelomeningocele?